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Health News Florida

Two Tampa men sentenced in multimillion-dollar health care fraud scheme

Daylina Miller/WUSF News
/

The two men and six others were accused of deceiving pharmacy benefit managers into approving tens of thousands of prescriptions that were fraudulently obtained.

Two Tampa men have been sentenced to prison after being convicted in multimillion-dollar health care fraud scheme.

Peter Bolos, 44, was sentenced to 14 years in prison, while Michael Palso, 48, was sentenced to 33 months in prison. Both were also ordered to pay more than $24.6 million dollars each in restitution.

Bolos, Palso and six others were accused of deceiving pharmacy benefit managers into approving tens of thousands of prescriptions that were fraudulently obtained, according to the U.S. Department of Justice. Private insurers such as Blue Cross Blue Shield of Tennessee, and public insurers, such as Medicaid and TRICARE, then paid pharmacies owned by the men for those prescriptions, a release from the justice department said.

“The scale of the prescription-drug fraud scheme orchestrated by Bolos and his conspirators was astonishing, and the 14-year sentence reflects the seriousness of Bolos’s participation in that conspiracy,” U.S. Attorney Francis M. Hamilton III for the Eastern District of Tennessee, said in the release. “The financial harm caused by health care fraud hurts all Americans, and the United States Attorney’s Office for the Eastern District of Tennessee will continue to support the cooperation among its federal law enforcement partners that is necessary to bring criminal swindlers like Bolos to justice.”

Bolos, Palso and another defendant owned Synergy pharmacy in Palm Harbor. They hired another defendant Scott Roix, to use his telemarketing company HealthRight to sell prescription medications to people by cold-calling them, according to the justice department. The customers would provide their insurance to pay for the drugs, which included pain creams, scar creams and vitamins, the release said.

Records show Bolos chose drugs that could be submitted for profitable reimbursements at inflated prices. HealthRight paid doctors who had never communicated with the patients to authorize the prescriptions, which is fraudulent, the release said.

In all, the defendants submitted $931 million in fraudulent claims and received a total of $174 million in paid billings, of which Bolos was responsible for $89 million, a release from the justice department said.

Bolos was convicted by a federal jury in December. Palso pleaded guilty to his role in the conspiracy. The remaining defendants, all of whom pleaded guilty, are scheduled to be sentenced.

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